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Written by JJ Barnes
On The Table Read, I interviewed author and retired GP Dr Tim Howard about his life, his career, and what inspired him to write his new novel, Let’s Kill All The Lawyers.
I am a retired doctor, a GP for most of my life, but also heavily involved in medical standards and ethics, and how to improve them, and how to influence and teach standards of practice. I finished up being one of the ‘judges’ who struck off doctors who failed in some way or another.
Like many GPs, I started up the specialist ladder, but found it hierarchical and restrictive, and felt that I could be more holistic by providing continuity of care for my patients as a GP. I also found it more intellectually challenging dealing with any problem that came through the door, rather than just one disease or group of diseases, as a specialist does.
I think I always have. I love literature, especially classical literature, but never had time to have a go at it. I also felt that writing a novel was a good way of getting a message across. Not many people have insight into how doctors think and work, and as I became more involved in ethical decision-making, I realized that a dry textbook was less likely to have an effect than a story in real time. There are so many ethical decisions facing doctors now – whether to resuscitate or not, end of life care, cost-effectiveness of treatment, and so on, that I wanted to bring some of these out in a story.
So, I first wanted to write many years ago, but never got round to it!
When I was being a medical judge, I had to write long ‘judgements’, explaining how and why a doctor had failed. This led me to try to think outside the legal framework required, and I joined a writing group to learn the nuts and bolts of story writing 10 years ago. I still attend it, and it is a brilliant stimulus.
About 2 years. I published it on Amazon at first, but that was unsatisfactory for all sorts of reasons, so I hawked it about in the usual way for a while, and then Brown Dog books took it up. The actual writing took about 6 months, and subsequent edits a further 6.
A strong desire to tell a specific story – that doctors are human too, and make mistakes, get tired and irritable, have personal issues to deal with, and so on. So that the way the public (some public) react to them if there is a mistake, even a perceived one, has a personal consequence for doctors. Lawyers tend to sue each other all the time, and don’t seem to worry too much about it. But doctors, perhaps because their role is to care for individuals as well as they can, take criticism badly, and find being blamed and sued deeply hurtful. I have counselled doctors who have been in complete emotional melt down because of being blamed or sued.
The legal culture of blame and retribution tends to make one’s mistakes (which we all make) something to defend, rather than to learn from.
To stop going off on one! In other words, to avoid banging on about one of my numerous hobby horses. There are so many interesting areas of debate in medical practice, and so many strong views, that it was easy to fall into the trap of becoming didactic and opinionated.
Two people: one, a brilliant and very senior Professor I worked for as a junior doctor, who despite being a world expert, had the common touch. The other, my father, a typical country GP of the 1950s and 60s, on call continuously for 30 years, loved by his patients, and a source of kindness and wisdom for his community. So much so that they named a street after him when he died. I am a 3rd generation GP (my son is 4th), but I could never achieve what he did.
Several patients I cared for. 95% of the public are nice normal sensible friendly people who it is a pleasure to care for. But there is a small subgroup who seem to set out to be unpleasant and manipulative. All doctors recognize them (they are called ‘heartsink patients’) –as do the police, social services and so on. They take up a huge amount of medical time, and also the time of other public services. They seem to have an axe to grind against society, and sadly, doctors are often the first in the firing line.
Having a complaint made against me when I had done my very best to help a patient. I thought I had done everything ok – got the diagnosis right, referred him, done the right tests, and so on, but he tried to take me to the cleaners. It hung over me like a sword of Damocles for 6 years, and nearly broke me.
The conflict between the law, justice, fairness, and the truth. I found, in my work in court, that there is a big gap between justice and fairness, and between truth and perception of events. And this can be very hurtful for someone accused of doing something that he/she didn’t do or mean to do. The adversarial system of courts and the law is about winning, not about getting at the truth.
The second conflict is about the law of diminishing returns for medical treatment. There is an argument that some of what doctors do is prolonging death rather than prolonging life, and I feel that this should be an area of honest public debate. We are keeping people alive for longer and longer with scant regard for quality of life. This spills over into the debate about having a ‘good death’.
Just let it pour out in an unstructured stream of consciousness! Then tried to knock it into some sort of readable shape.
I did the first few edits myself, and then got a wise friend with writing expertise to edit it quite fiercely. I also paid for an edit by a so-called professional editor, which was useless – subjective and opinionated.
Go for it! If you’ve got a story to tell, just tell it. It may start off unformed, and without an end, but if the characters are there, let them talk and do their thing. We’re not all Le Carre’s, writing intricate charts of plot lines; if something goes off piste with the story line (and mine certainly did) bin that bit, go for a brisk walk, and try again.
I’ve got a collection of short stories and talking heads just about ready to go. I hugely enjoy writing cynically witty short stories which demonstrate the bizarre characters and situations we all come across from time to time.
Definitely yes. That may be something to do with the boast of being a published author, or of ‘leaving footprints in the sands of time’. But it has been huge fun, and a steep learning curve.
“Let’s Kill all the Lawyers”, by Tim Howard. Publisher – Brown Dog Books. ISBN 978-1-83952-330-4 eBook 978-1-83952-331-1
Twitter: @DrTimGHoward
Facebook: Tim Howard (good review of the book on Facebook!)
Instagram timhoward842
Email: timhoward767@gmail.com
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